BID FORMS.pdf

REQUIRED FORMS,

CERTIFICATIONS & AFFIDAVITS

BID FORM #1

TO: COMMISSIONERS OF CAMBRIDGE

DEPARTMENT OF PUBLIC WORKS

1025 WASHINGTON STREET

CAMBRIDGE, MARYLAND 21613

Gentlemen:

Proposal of (hereinafter called “BIDDER” or “CONTRACTOR”), organized and existing under the laws of the State of ______________________ doing business as (Insert “a corporation”, “a partnership”, or “an individual” as applicable.) to COMMISSIONERS OF CAMBRIDGE, MARYLAND (hereinafter call “OWNER” or

“CITY”).

In compliance with your Invitation for Bids for Bids, BIDDER hereby proposes to perform all WORK for the On-Call Traffic Calming Project in strict accordance with the CONTRACT DOCUMENTS, within the time set forth therein, and at the prices stated below, except that not more than 49% of the Work maybe subcontracted to a firm listed below.

BIDDER hereby agrees to promptly commence work under this contract upon issuance of notice to proceed.

BIDDER acknowledges receipt of the following ADDENDUM:

# DATE

Witness Signature of Authorized Person

Firm Name Title

Date: Business Address

Subcontractors

Firm Name Business Address Point of Contact/Phone #

I certify that that all firms meet all requirements and certifications to do business under this Contract as if they were the prime contractor.

Name Signature of Authorized Person

Date

Certification Regarding Debarment, Suspension, and Other Responsibility Matters--Primary Covered Transactions

The BIDDER certifies to the best of its knowledge and belief, that it and its principals:

(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency;

(2) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and

(4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default.

Certification for Contracts, Grants, Loans, and Cooperative Agreements Regarding Lobbying

(a) The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,'' in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

(b) This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.